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Respir Med. 2014 Mar;108(3):453-62. doi: 10.1016/j.rmed.2013.12.003. Epub 2013 Dec 16.

A home telehealth program for patients with severe COPD: the PROMETE study.

Author information

1
Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain. Electronic address: gsegrelles@hotmail.com.
2
Linde Healthcare, The Linde Group, Spain.
3
Epidemiology and Clinical Research Program, CIMERA, Bunyola, Illes Balears, Spain.
4
Pneumology Service, La Princesa Institute for Health Research (IP), Hospital Universitario de la Princesa, Madrid, Spain.
5
Goya Primary Care Center, Spain.
6
Montesa Primary Care Center, Spain.
7
Hospital Universitario de la Princesa, Madrid, Spain.
8
Department of Medical Research and Documentation, Hospital Universitario de la Princesa, Madrid, Spain.

Abstract

BACKGROUND:

Acute exacerbations of chronic obstructive pulmonary disease (AECOP) are key events in the natural history of the disease. Patients with more AECOPD have worse prognosis. There is a need of innovative models of care for patients with severe COPD and frequent AECOPD, and Telehealth (TH) is part of these programs.

METHODS:

In a cluster assignment, controlled trial study design, we recruited 60 patients, 30 in home telehealth (HT) and 30 in conventional care (CC). All participants had a prior diagnosis of COPD with a post-bronchodilator forced expiratory volume (FEV1)% predicted <50%, age ≥ 50 years, were on long-term home oxygen therapy, and non-smokers. Patients in the HT group measured their vital signs on a daily bases, and data were transmitted automatically to a Clinical Monitoring Center for followed-up, and who escalated clinical alerts to a Pneumologist.

RESULTS:

After 7-month of monitoring and follow-up, there was a significant reduction in ER visits (20 in HT vs. 57 in CC), hospitalizations (12 vs. 33), length of hospital stay in (105 vs. 276 days), and even need for non-invasive mechanical ventilation (0 vs. 8), all p < 0.05. Time to the first severe AECOPD increased from 77 days in CC to 141 days in HT (K-M p < 0.05). There was no study withdrawals associated with technology. All patients showed a high level of satisfaction with the HT program.

CONCLUSIONS:

We conclude that HT in elderly, severe COPD patients with multiple comorbidities is safe and efficacious in reducing healthcare resources utilization.

KEYWORDS:

COPD; Comorbidities; Elderly; Hospitalizations; Telehealth; Telemedicine

PMID:
24433744
DOI:
10.1016/j.rmed.2013.12.003
[Indexed for MEDLINE]
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